Topic Contents

Healthy Eating for Children

Topic Overview

What is healthy eating?

Healthy eating means
eating a variety of foods so that your child gets the
nutrients (such as
protein,
carbohydrate, fat,
vitamins, and
minerals) he or she needs for normal growth. If your
child regularly eats a wide variety of basic foods, he or she will be
well-nourished.

How much food is good for your child?

With babies and toddlers, you can usually leave it to them to eat the right amount of food at each meal, as long as you make only healthy foods available.

Babies cry to let us know they're hungry. When they're full, they stop eating. Things get more complicated at age 2 or 3, when children begin to prefer the tastes of certain foods, dislike the tastes of other foods, and have a lot of variation in how hungry they are. But even then it usually works best to make only healthy foods available and let your child decide how much to eat.

It may worry you to see your
child eat very little at a meal. Children tend to eat the same number of
calories every day or two if they are allowed to decide how much to eat. But the pattern of calorie intake may vary from day to day. One
day a child may eat a big breakfast, a big lunch, and hardly any dinner. The
next day this same child may eat very little at breakfast but may eat a lot at
lunch and dinner. Don't expect your child to eat the same amount of food at
every meal and snack each day.

How can you help your child eat well and be healthy?

Many parents worry that their
child is either eating too much or too little. Perhaps your child only wants to
eat one type of food—peanut butter and jelly sandwiches, for instance. One way
to help your child eat well and help you worry less is to know what your job is
and what your child's job is when it comes to eating. If your child only wants to eat one type
of food, he or she is doing the parent's job of deciding what food choices are.
It is the parent's job to decide what foods
are offered.

Your job is to offer
nutritious food choices at meals and snack times. You decide the
what, where, and when of eating.

Your child's job is to choose how much he or she will
eat of the foods you serve. Your child decides how much
or even whether to eat.

If this idea is new to you, it may take a little time for
both you and your child to adjust. In time, your child will learn that he or
she will be allowed to eat as little or as much as he or she wants at each meal
and snack. This will encourage your child to continue to trust his or her
internal hunger gauge.

Here are some ways you can help support your child's healthy
eating habits:

Eat together as a family as often as
possible. Keep family meals pleasant and positive. Avoid making comments about
the amount or type of food your child eats. Pressure to eat actually reduces
children's acceptance of new or different foods.

Make healthy
food choices for your family's meals. Children notice the choices you make and
follow your example.

Make meal times fairly predictable. Eat at around the same times every day and always at the table, even for snacks.

Have meals often enough (for example, about every 3 hours for toddlers) that your child doesn't get too hungry.

Offer only water between meals so that your child is as hungry as he or she can be for the next meal. When children are hungry, it's easier to get them to eat something they don't like a lot.

Do nothing else during the meal other than talking and enjoying each other—no TV or other distractions.

Here are some other ways you can help your child stay healthy:

Set limits on your child's daily television and computer time.
The American Academy of Pediatrics recommends limiting TV and other screen time to 2
hours or less a day.1 Sit down with your
child and plan out how he or she will use this time allowance.
It's best for children younger than 2 to not watch TV, watch movies, or play games on a screen.

Make physical activity a part of your family's daily life. For example, walk your child to and from school and take a walk after dinner. Teach your young child how to skip, hop, dance, play catch, ride a bike, and more. Encourage your older child to find his or her favorite ways to be active.

Take your child to all recommended well-child checkups. You
can use this time to discuss with a doctor your child's growth rate, activity level, and
eating habits.

What causes poor eating habits?

Poor eating habits
can develop in otherwise healthy children for several reasons. Infants are born
liking sweet tastes. But if babies are going to learn to eat a wide variety of
basic foods, they need to learn to like other tastes, because many nutritious
foods don't taste sweet.

Available food choices. If candy and soft drinks are always available, most children
will choose these foods rather than a more nutritious snack. But forbidding
these choices can make your child want them even more. You can include some
less nutritious foods as part of your child's meals so that he or she learns to
enjoy them along with other foods. Try to keep a variety of nutritious and appealing food
choices available. Healthy and kid-friendly snack ideas include:

String cheese.

Whole wheat
crackers and peanut butter.

Air-popped or low-fat microwave
popcorn.

Frozen juice bars made with 100% real
fruit.

Fruit and dried fruit.

Baby carrots with hummus
or bean dip.

Low-fat yogurt with fresh fruit.

The need for personal choice. Power struggles between a parent and child can affect eating
behavior. If children are pressured to eat a certain food, they are more likely
to refuse to eat that food, even if it is something they usually would enjoy.
Provide a variety of nutritious foods. Your
child can decide what and how much he or she will eat from the choices
you offer.

Emotion. A child's sadness,
anxiety, or family crisis can cause undereating or overeating. If you think
your child's emotions are affecting his or her eating, focus on resolving the
problem that is causing the emotions instead of focusing on the eating
behavior.

If your child is healthy and eating a nutritious and
varied diet, yet seems to eat very little, he or she may simply need less food energy
(calories) than other children. And some children need more daily
calories than others the same age or size, and they eat more than you might
expect. Every child has different calorie needs.

In rare cases, a
child may eat more or less than usual because of a medical condition that
affects his or her appetite. If your child has a medical condition that affects
how he or she eats, talk with your child's doctor about how you can help your
child get the right amount of nutrition.

What are the risks of eating poorly?

A child with
poor eating habits is going to be poorly nourished. That means he or she won't be
getting the amounts of nutrients needed for healthy growth and development.
This can lead to being underweight or overweight. Poorly nourished children
tend to have weaker
immune systems, which increases their chances of
illness. Poor eating habits can increase a child's risk for
heart disease, high blood pressure, type 2 diabetes, or high cholesterol later in life.

Poor eating
habits include:

Eating a very limited variety of
foods.

Refusing to eat entire groups of foods, such as
vegetables.

Eating too many foods of poor nutritional quality, such
as soft drinks, chips, and doughnuts.

Overeating from being
served large portions or being told to "clean your plate" or "finish
it all up."

Changing Your Family's Eating Habits

Healthy eating
means eating a variety of foods from all food groups. It means choosing fewer
foods that have lots of fats and sugar. But it does not mean that your child
cannot eat desserts or other treats now and then.

With a little
planning, you can create a structure that gives your child (and you) the
freedom to make healthy eating choices. Think of this as planning not just for
the kids but for everyone in your family.

First steps

Set up a regular snack and meal schedule. Kids
need to eat at least every 3 to 4 hours. Most children do well with three meals
and two or three snacks a day.

Eat meals together as a family as
often as possible.

Start with small, easy-to-achieve changes, such
as offering more fruits and vegetables at meals and snacks.

Look
at your portion sizes. Remember that younger children may eat smaller amounts
than adults. Although paying attention to portion sizes is important
(especially of less nutritious foods), it is up to your child to decide how
much food he or she needs to eat at a meal to feel full.

Slowly cut down on soda pop and other high-sugar drinks. Serve water to
quench thirst. You can encourage your child to drink more water and fewer
sugar-sweetened drinks by keeping cold water on hand in the
refrigerator.

At meals, serve milk. (Children under 12 months of age should not drink cow's milk.) Most children need whole milk between 1 and 2 years of age. But your doctor may recommend 2% milk if your child is overweight or if there is a family history of obesity, high blood pressure, or heart disease. Over the age of 2, serve fat-free or low-fat milk.

Consider meeting with a
registered dietitian for help with meal and snack
planning (nutritional counseling).

When trying new foods at
a meal, be sure to also include a food that your child likes. Don't be
discouraged if it takes several tries before your child actually eats a new
food. It may take as many as 15 times or more before your child will
try a new food.

Even though your child may not eat the food, it is important to
keep serving it so that your child can see other family members enjoying it.
Also, your child should not think that meals are going to be planned only
around his or her food preferences. Remember, you are in charge of deciding
which foods are served at meal and snacks.

If you are feeling out of control over your own eating
habits or weight, your child may be learning some poor eating habits from you.
See a registered dietitian, your doctor, or a mental health professional
experienced with eating problems, if needed. For more information, see the
topics
Healthy Eating and
Weight Management.

Encourage healthy choices

Help your child learn to
make healthy food and lifestyle choices by following these steps:

Be a good role model. Practice the eating and
exercise habits you'd like your children to have. Your example is your child's
most powerful learning tool.

Increase active time. Make physical
activity a part of your family's daily life. Set limits on your child's daily
TV and computer time to no more than 2 hours a day. Have your child take breaks from computer, cell phone, and TV use and be active instead. It's best for children younger than 2 to not watch TV, watch movies, or play games on a screen.

Eat breakfast.
Having breakfast with your child can help start a lifelong healthy
habit.

Involve your child in meal planning and grocery shopping.
When your child is old enough, teach him or her about food preparation, cooking
and food safety and, later, how to use
food label information. While giving your child a role in decision making, remember
that you have the final say in food planning.

Involve your child in cooking. Children enjoy helping out, and
they learn easily with hands-on experience. They can also use other skills,
such as math, when counting or measuring ingredients.

Helping Your Child to Eat Well

Setting the stage for pleasant mealtimes

Make a
point to eat as many meals together at home as possible. A regular mealtime
gives you and your family a chance to talk and relax together. It also helps
you and your child to have a positive relationship with food.

Think of the family meal table as a
conflict-free zone where you each come for positive time together. Save problem
solving and difficult discussions for a separate time and place.

Save distractions, such as reading, toys, television watching, or
answering the phone, for another time and place.

Teach and model
good table manners and respectful behavior.

No more power struggles—learning to trust your child's choices during meals and snacks

Most children self-correct their undereating, overeating, and
weight problems when the power struggle is taken out of their mealtimes. But
the hardest part for most parents is stopping themselves from directing their
children's choices ("Eat at least one bite of vegetable." "That's a lot of
bread you're eating." "Clean your plate." "No seconds."). Do your best to avoid
commenting.

If your child skips over certain foods, eats lightly,
or eats more than you'd like:

Check yourself. Remember that your child has
an internal hunger gauge that controls how much to eat. If you override those
signals, your child won't be able to tune into that internal hunger gauge as
easily.

Let your child decide when he or she is full. You can
remind children of the next scheduled meal or snack time by telling them,
for example, "You can eat as much or as little as you want now. We will have
our next snack at 4 o'clock."

Expect some rebellion as you change the way you feed your
family. At first, your child may eat only one type of food, eat everything in
sight, or stubbornly refuse to eat anything. Fortunately, no harm is done if
your child chooses to eat too much or skips a meal once in a while.

Gradually, your child's eating habits will balance out. You'll notice
that, as long as you provide nutritious choices, your child will eat a healthy
variety and amount of food each week. Try to relax, and you'll see your child relax too.

Adjusting your approach based on your child's age

Feeding your infant. From birth, infants follow
their internal hunger and fullness cues. They eat when they're hungry, and they
stop eating when they're full. Experts recommend that newborns be fed on
demand.

Feeding your toddler/preschooler. As you introduce your young child to new foods, you are encouraging a love of variety, texture, and
taste. This is important, because the more adventurous your child feels about foods,
the more balanced and nutritious his or her weekly intake will be. Remember
that you may need to present a new or different food a number of times before your child will be comfortable trying it. This is normal. The best approach
is to offer the new food in a relaxed manner without pressuring your
child.

Feeding your teen. When your child
becomes a teen, he or she has a lot more food choices outside the home. You are still responsible for
providing balanced meals in the home. Family mealtimes become especially
important.

Getting help for your child's eating habits

If you are worried about your child's eating habits, you can call your
family doctor for help. He or she can advise you on actions you can take or
direct you to someone with specific expertise, such as:

Registered dietitians, who teach people
about nutrition or develop diets to promote health. They can also specialize in
counseling to help treat food-related problems, including
eating disorders.

Primary care pediatricians, who may have special training and experience in
caring for children who have eating issues.

Therapists or counselors, who can help your family cope with eating disorders and
with power struggles about eating.

Psychiatrists, who can provide counseling and
medicine.

Pediatric gastroenterologists, who
can rule out or treat conditions of the digestive system, which could cause an
eating problem.

Pediatric endocrinologists,
who can rule out or treat hormone conditions that can lead to weight problems.

Call your doctor if:

Your child has a major change in appetite or weight. This could
include eating too much or too little, or gaining or losing weight.

Eating issues have turned your family's mealtimes into a
battleground.

You suspect that your child may have an
eating disorder, such as
anorexia or
bulimia.

Other Places To Get Help

Organizations

Centers for Disease Control and Prevention (CDC):
Division of Nutrition, Physical Activity and Obesity

1600 Clifton Road

Atlanta, GA 30333

Phone:

1-800-CDC-INFO (1-800-232-4636)
(404) 639-3311

TDD:

1-888-232-6348

Web Address:

www.cdc.gov/nccdphp/dnpao/index.html

This Web site has information about healthy weight, nutrition, and physical activity for people of all ages.

Academy of Nutrition and Dietetics

120 South Riverside Plaza

Suite 2000

Chicago, IL 60606-6995

Phone:

1-800-877-0877

Email:

knowledge@eatright.org

Web Address:

www.eatright.org

The Academy of Nutrition and Dietetics sets standards for all types of prescribed diets. The
organization produces a variety of consumer information, including videos. This group will help you find a registered dietitian in your area who
provides nutrition counseling.

American Academy of Pediatrics

141 Northwest Point Boulevard

Elk Grove Village, IL 60007-1098

Phone:

(847) 434-4000

Fax:

(847) 434-8000

Web Address:

www.aap.org

The American Academy of Pediatrics (AAP) offers a
variety of educational materials about parenting,
general growth and development, immunizations, safety, disease prevention, and more. AAP guidelines for various conditions and links to other
organizations are also available.

KidsHealth for Parents, Children, and
Teens

Nemours Home Office

10140 Centurion Parkway

Jacksonville, FL 32256

Phone:

(904) 697-4100

Web Address:

www.kidshealth.org

This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.

National Agricultural Library:
Nutrition.gov

10301 Baltimore Avenue

Beltsville, MD 20705

Phone:

(301) 504-5414

Fax:

(301) 504-6409

Web Address:

www.nutrition.gov

This Web site has information on nutrition, healthy
eating, exercise, and food safety. You can use an e-mail form to ask a
food-related question.

We Can! (Ways to Enhance Children's Activity
and Nutrition)

P.O. Box 30105

Bethesda, MD 20824-0105

Phone:

(301) 592-8573

Fax:

(240) 629-3246

TDD:

(240) 629-3255

Email:

nhlbiinfo@nhlbi.nih.gov

Web Address:

http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/

We Can or "Ways to Enhance Children's Activity
& Nutrition" is a national program designed for families and communities to
help children achieve a healthy weight. The program focuses on three important
behaviors: improved food choices, increased physical activity, and reduced
screen time.

References

Citations

Other Works Consulted

American Academy of Pediatrics (2010). Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0–3 years of age). Pediatrics, 126(5): 1040–1050. Available online: http://pediatrics.aappublications.org/cgi/content/full/126/5/1040.

Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents (2011). Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: Summary report. Pediatrics, 128(Suppl 5): S213–S256.

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